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Alabama Medicaid

(VM041)
Sunday, February 28, 2021
TPL Supporting Documentation may now be uploaded electronically through the Web Portal using the Digital Upload form and selecting “Attachments” for the Form Type.

CMS discontinued the RY2020 Payment Error Rate Measurement (PERM) Audit for Medicaid and CHIP due to the COVID-19 pandemic, and will not report state specific errors for this cycle. Providers may close any pending requests for medical records received from NCI AdvanceMed, Inc.

Attention ACHN Providers: Changes have been made to the bonus payment distribution. See the “Changes to the Alabama Coordinated Health Network (ACHN) Bonus Payment Distribution” ALERT on the Medicaid website for more details.
https://medicaid.alabama.gov/alert_detail.aspx?ID=14192

All previously published expiration dates related to the Coronavirus (COVID-19) emergency are once again extended by the Alabama Medicaid Agency. The new expiration date is the earlier of March 31, 2021, the conclusion of the COVID-19 National emergency, or any expiration date noticed by the Alabama Medicaid Agency through a subsequent ALERT. A listing of previous Provider ALERTs and notices related to the health emergency is available by selecting the Agency’s COVID-19 page in the bottom section: https://medicaid.alabama.gov/news_detail.aspx?ID=13729
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Software Download

Provider Electronic Solution Software

PLEASE REVIEW PRIOR TO SELECTING AN OPTION FOR SOFTWARE DOWNLOAD

Provider Electronic Solutions Software version 3.11 is now available.

• Software version 3.11 includes the addition of the PWK Segment(Electronic Attachments) to all 837 Claim Forms.

• Software version 3.11 includes the addition of the incentive Amount field to the Pharmacy claim form.

• Software version 3.10 includes updates to NCDCP Pharmacy form to include conflict code ingredient duplication and update 837 Professional claim form to include new maternity date fields.

• Software version 3.09 includes changing "RCO" references to "MCO" on eligibility response file and removing message regarding RCO from claim status response. Change field label on 837 claim forms crossover tab and eligibility response to display Medicare ID field label instead of HIC Number.

• Software version 3.08 includes updates to DXC logos and defaults ICD version to ICD 10.

• Software version 3.07 includes updates to allow up to 3 birthweights, and new inpatient admit source codes.

Please refer to Appendix C Change Log in the software User Manual for a full list of the changes included in the new Provider Electronic Solution software version.

ICD-10 RELATED NOTES:

• Software version 3.02 and all subsequent software versions will include changes for ICD-10.
• ICD-10 codes should not be submitted until the CMS mandated date of October 1, 2015.
• The ICD version on new Claims and Prior Authorizations will default to blank.
• The Procedure/HCPCS and Diagnosis list are split based on ICD version.
• Users may begin building ICD-10 lists now.

• Users must perform an upgrade through each software version to successfully upgrade an older version of a database.

LTC Admission Notification

Documentation